PAHO/WHO, health min­istry to start work on al­co­hol con­trol pol­icy

Stabroek News Sunday - - FRONT PAGE - By Zoisa Fraser

In the com­ing days, the Pan Amer­i­can Health Or­gan­i­sa­tion and World Health Or­gan­i­sa­tion (PAHO/WHO), with in­put from the Pub­lic Health Min­istry and stake­hold­ers, will be­gin de­vel­op­ing a pol­icy for the pre­ven­tion and con­trol of use of al­co­hol in Guyana.

The project, which will be spear­headed by con­sul­tant Dr. Nor­man Gies­brecht, who has a record of con­duct­ing re­search fo­cused on al­co­hol pol­icy de­vel­op­ment, will cul­mi­nate in Fe­bru­ary, 2019, with the sub­mis­sion of the fi­nal pol­icy doc­u­ment.

The pol­icy’s Terms of Ref­er­ence (ToRs) state that in the quest to ac­cel­er­ate the im­ple­men­ta­tion of the global agenda for al­co­hol pre­ven­tion and con­trol in Guyana, the Min­istry re­quested sup­port for the de­vel­op­ment of a pol­icy that is aligned with the Global Strat­egy to Re­duce the Harm­ful Use of Al­co­hol 2016 and the WHO “Best Buys” for al­co­hol pre­ven­tion and con­trol.

“Even though pre­ven­tion of al­co­hol and sub­stance use and re­lated dis­or­ders are in­cluded in the agenda of the Na­tional Health Strat­egy for Guyana 2013-2020 (Health Vi­sion 2020) and the Men­tal Health Ac­tion Plan 2015-2020, the coun­try is still lag­ging with re­gard to the im­ple­men­ta­tion of the WHO “Best Buys” (cost­ef­fec­tive in­ter­ven­tions) to pre­vent and con­trol al­co­hol use and abuse, es­pe­cially among youth and in­dige­nous pop­u­la­tions in the coun­try,” the ToRs, which were seen by the Sun­day Stabroek state.

The Global Strat­egy to Re­duce the Harm­ful Use of Al­co­hol, ac­cord­ing to the WHO web­site, fo­cuses on ten key ar­eas of pol­icy op­tions and in­ter­ven­tions at the na­tional level and four pri­or­ity ar­eas for global ac­tion.

The ten ar­eas for na­tional ac­tion are: lead­er­ship, aware­ness and com­mit­ment; health ser­vices’ re­sponse; com­mu­nity ac­tion; drunk-driv­ing poli­cies and coun­ter­mea­sures; avail­abil­ity of al­co­hol; mar­ket­ing of al­co­holic bev­er­ages; pric­ing poli­cies; re­duc­ing the neg­a­tive con­se­quences of drink­ing and al­co­hol in­tox­i­ca­tion; re­duc­ing the pub­lic health im­pact of il­licit al­co­hol and in­for­mally pro­duced al­co­hol; and mon­i­tor­ing and sur­veil­lance.

The four pri­or­ity ar­eas for global ac­tion are: pub­lic health ad­vo­cacy and part­ner­ship; tech­ni­cal sup­port and ca­pac­ity build­ing; pro­duc­tion and dis­sem­i­na­tion of knowl­edge; and re­source mo­bi­liza­tion.

The “Best Buys” doc­u­ment, which lists harm­ful al­co­hol use as a risk fac­tor/dis­ease, pro­poses that there be tax in­creases, re­stricted access to re­tailed al­co­hol and bans on al­co­hol ad­ver­tis­ing. This doc­u­ment fo­cuses on “Re­duc­ing the Eco­nomic Im­pact of Non-Com­mu­ni­ca­ble Dis­eases in Low and Mid­dle-In­come Coun­tries.”

It is ex­pected that Dr. Gies­brecht will sub­mit a draft re­port some­time be­tween Jan­uary 28 and Fe­bru­ary 1, 2019 and sub­mit the fi­nal re­port some­time dur­ing the pe­riod Fe­bru­ary 18-22, 2019.

Based on Dr. Gies­brecht’s sched­ule, work will be­gin on Oc­to­ber 22. Dur­ing the first week, at­ten­tion will be paid to the de­vel­op­ment and sub­mis­sion of a draft out­line for the pos­si­ble struc­ture and con­tent of the pol­icy doc­u­ment.

Ac­cord­ing to his CV (which spans 55 pages), Dr. Gies­brecht is cur­rently the Emer­i­tus Sci­en­tist at the Cen­tre for Ad­dic­tion and Men­tal Health (CAMH) and has sev­eral publi­ca­tions re­lated to al­co­hol. He wrote the na­tional al­co­hol strat­egy for Canada.

He is also the re­cip­i­ent of the Life­time Achieve­ment Award from the Amer­i­can Pub­lic Health As­so­ci­a­tion’s Al­co­hol, To­bacco and other Drugs Sec­tor.

Months af­ter tak­ing of­fice, Pres­i­dent David Granger had reg­is­tered his con­cern about ex­ces­sive drink­ing and as­so­ci­ated deaths, par­tic­u­larly on the road­ways.

Al­co­hol is also said to be a ma­jor contributing fac­tor in the large num­ber of sui­cides and sex­ual as­saults which have been oc­cur­ring in Baramita, in Re­gion One, over the years.

Pres­i­dent Granger had de­scribed al­co­hol as “one of two evils” that the coun­try has to con­tain and as­sured that, over time, mea­sures would be put in place to deal with it.

Pub­lic Se­cu­rity Min­is­ter Khem­raj Ram­jat­tan, last year had also reg­is­tered his con­cern and ex­pressed his will­ing­ness to work along with the min­is­ters of So­cial Co­he­sion, Pub­lic Health and Ed­u­ca­tion to as­sist in bring­ing the al­co­hol abuse sit­u­a­tion in the coun­try un­der con­trol. “It is a dis­ease in this coun­try,” he had stressed, be­fore also not­ing that en­force­ment of ex­ist­ing reg­u­la­tions to curb ex­ces­sive drink­ing is needed.

‘Se­ri­ous prob­lem’

Mean­while, Dr. Wil­liam Adu-Krow, PAHO’s coun­try Di­rec­tor, dur­ing a re­cent in­ter­view, ac­knowl­edged that al­co­hol con­sump­tion in Guyana is a prob­lem.

Quot­ing statis­tics, he told Sun­day Stabroek that world­wide, con­sump­tion is about 6.2 litres per per­son com­pared with 9.4 litres in the Caribbean alone. He did not have fig­ures for Guyana. These fig­ures, which were recorded in 2010, per­tain to pure al­co­hol and fo­cuses on per­sons aged 15 years or older.

The ToRs for the up­com­ing con­sul­tancy state that a quar­ter of this con­sump­tion (24.8%) was un­recorded; that is, a quar­ter of the al­co­hol con­sumed was ei­ther home­made or il­le­gally pro­duced or sold out­side nor­mal gov­ern­ment con­trols.

Of the to­tal recorded al­co­hol con­sumed world­wide, it states that 50.1% was con­sumed in the form of spir­its.

They add that in all WHO re­gions, fe­males are more of­ten life­time ab­stain­ers than males. In 2012, about 3.3 mil­lion deaths, or 5.9% of all global deaths, were at­trib­ut­able to al­co­hol con­sump­tion, they said fur­ther, be­fore not­ing that there are sig­nif­i­cant sex dif­fer­ences in the pro­por­tion of global deaths at­trib­ut­able to al­co­hol. For ex­am­ple, in 2012, 7.6% of deaths among males and 4.0% of deaths among fe­males were at­trib­ut­able to al­co­hol.

Dr. Adu-Krow high­lighted the fact that al­co­hol is a contributing fac­tor in homi­cides, sui­cides and road ac­ci­dents.

Not­ing that in Guyana it is spir­its which ac­count for about 77% of the al­co­hol con­sumed, he added that beer ac­counts for al­most 23% and wine for un­der 1%. “That means that the per­sons who ac­tu­ally deal with al­co­hol, they deal with the rum…the very, very strong al­co­hol,” he pointed out.

He also noted the dire ef­fects that ex­ces­sive al­co­hol con­sump­tion has on the fam­ily, in­clud­ing school-aged chil­dren, the com­mu­nity, the work­place, health and the coun­try’s health care sys­tem.

Ac­cord­ing to the coun­try rep, there has al­ways been vary­ing opin­ions on what con­sti­tutes ir­re­spon­si­ble drink­ing. He said that the gen­eral view is that con­sum­ing more than four drinks amounts to ir­re­spon­si­ble drink­ing. The limit, he said, is four drinks per oc­ca­sion for women or five for men.

Al­co­hol is one of the fo­cal points for

Dr. Nor­man Gies­brecht

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